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AC` " °® CERTIFICATE OF LIABILITY INSURANCE
<br />0ATE 8 /2 /201Y "'
<br />08/27/2014
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER 1 -000- 000 -0000
<br />Marsh Risk and Insurance Services
<br />CONTACT
<br />NAME:
<br />On, Ea : 888- 769 -3873 FAX No:
<br />345 California Street
<br />Suite 1300
<br />ADDRESS:
<br />San Francisco, CA 94104
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC#
<br />INSURER A: NATIONAL UNION FIRE INS CO OF PITTS
<br />19445
<br />INSURED
<br />INSURER B: ZURICH AMER INS CO
<br />16535
<br />ORS Corporation
<br />dba URS Corporation Americas
<br />INSURER C: SEE ATTACHED
<br />INSURER D: LEXINGTON INS CO
<br />19437
<br />2020 E. First Street, Suite 400
<br />INSURER E: Lloyd's of London & British Companies
<br />PERSONAL B ADV INJURY
<br />Santa Ana, CA 92705
<br />INSURER F:
<br />• XCU, BFPD
<br />COVERAGES CERTIFICATE NUMBER: 41205545 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />IN SR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDIYYW
<br />POLICY EXP
<br />MMIDDIYYYY
<br />LIMITS
<br />A
<br />GENERAL LIABILITY
<br />GL5388391
<br />09/01/1
<br />09/01/15
<br />EACH OCCURRENCE
<br />$ 2,000,000
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE OCCUR
<br />DAMAGE RE TED
<br />PREMISES eaccurcence
<br />$ 1,000,000
<br />MED EXP(Any one person)
<br />$ 10,000
<br />PERSONAL B ADV INJURY
<br />$ 2,000,000
<br />• XCU, BFPD
<br />•
<br />Contractual Liability
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />GENL AGGREGATE
<br />LIMIT APPLIES PER:
<br />PRODUCTS - COMPIOP AGO
<br />$2,000,000
<br />POLICY
<br />T PRO LOC
<br />$
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />BAP938521505
<br />09/01/14
<br />09/01/15
<br />OMBI EDtSINGLE LIMIT
<br />2,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />X
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />r[ [pp Btl
<br />BODILY INJURY (Par accident)
<br />$
<br />POPERTYl DAMAGE
<br />e
<br />$
<br />NON-OWNED
<br />HIRED AUTOS NO
<br />R -, Y,('A LL
<br />U MBRELLA LIAB
<br />EXCESS LIAB
<br />OCCUR
<br />CLAIMS -MADE
<br />p �0 5 l
<br />V �, L DD
<br />EACH OCCURRENCE
<br />$
<br />AGGREGATE
<br />$
<br />DED RETENTION$
<br />$
<br />G•
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY Y I N
<br />SEE ATTACHED
<br />O1 /O1 /1
<br />01/01/15
<br />X WRVLATI' OT&
<br />E.L. EACH ACCIDENT
<br />52,000,000
<br />ANY PROPRIETORIPARTNERIEXECUTIVE
<br />OFFICERIMEMBER EXCLUDED? NN
<br />NIA
<br />E.L. DISEASE -EA EMPLOYEE
<br />$ 2,000,000
<br />(Mandatory In NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 2,000,000
<br />D
<br />Prof Liab w /Lmtd Contract
<br />015438088
<br />09/01/1
<br />09/01/15
<br />Each Claim / Agig
<br />E
<br />ClaimsMade Retro 11 -17 -38
<br />PE1410213
<br />09/01/1
<br />09/01/15
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives are included as Additional
<br />Insureds as respects the General Liability policy, where required by written contract. This insurance is Primary over
<br />any similar insurance available to any person or organization we have added to this policy as Additional Insureds.
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2010105)
<br />JE111ottURS
<br />41205545
<br />© 1988 -2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />A_ZD 3 .- 12. 1
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />City of Santa Ana
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />20 Civic Center Plaza - Ross Annex (M -36)
<br />AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92701
<br />I Yom.
<br />USA
<br />ACORD 25 (2010105)
<br />JE111ottURS
<br />41205545
<br />© 1988 -2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />A_ZD 3 .- 12. 1
<br />
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